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<html lang="en">
  <head>
    <meta charset="utf-8">
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    <meta name="viewport" content="width=device-width, initial-scale=1">
    <meta name="description" content="">
    <title>进修人员报名表</title>
    <link rel="stylesheet" media="screen" href="../../../front/css/daimabiji.css" />
    <link href="https://cdn.bootcss.com/bootstrap/3.3.7/css/bootstrap.min.css" rel="stylesheet">
  </head>
   <body>
        <form id="msform"  action="{:url('savemsg')}" method="post" enctype="multipart/form-data" class="form-horizontal" onsubmit="return check()">
                <fieldset>
                    <h2 class="fs-title">申请人信息</h2>
                    <h3 class="fs-subtitle">This is step 1</h3>
                    <div class="form-group">
                        <input class="form-control" type="text" name="name" placeholder="姓名" />
                    </div>
                   <div class="form-group">
                        <select name="sex" class="form-control">
                                <option value="男" selected="selected">男</option>  
                                <option value="女">女</option>  
                        </select> 
                   </div>
                   <div class="form-group">
                        <input class="form-control" type="text" name="identityno" placeholder="身份证号" />
                   </div>
                   <div class="form-group">
                        <input id="telphone" class="form-control" type="text" name="telphone" placeholder="手机号" />
                   </div>
                   <div class="form-group">
                        <select name="title" class="form-control">
                                <option>--请选择职称--</option>  
                                <option value="主任医师">主任医师</option>  
                                <option value="副主任医师">副主任医师</option>  
                                <option value="主治医师">主治医师</option>  
                                <option value="住院医师">住院医师</option>
                                <option value="主任技师">主任技师</option>  
                                <option value="副主任技师">副主任技师</option>
                                <option value="主管技师">主管技师</option>  
                                <option value="初级技师">初级技师</option>
                                <option value="药师">药师</option>
                        </select> 
                   </div>
                   <div class="form-group">
                        <!-- <input class="form-control" type="text" name="department" placeholder="进修科室" /> -->
                        <select name="department" class="form-control">
                            <option>--进修科室--</option>  
                            <option value="神经内科">神经内科</option>  
                            <option value="消化内科">消化内科</option>  
                            <option value="妇产科">妇产科</option>  
                            <option value="康复医学科">康复医学科</option>
                            <option value="老年科">老年科</option>  
                            <option value="呼吸科">呼吸科</option>
                            <option value="血液科">血液科</option>  
                            <option value="皮肤科">皮肤科</option>
                            <option value="神经内科">内分泌及代谢病科</option>  
                            <option value="消化内科">心血管内科</option>  
                            <option value="妇产科">心血管内科</option>  
                            <option value="康复医学科">肾脏内科</option>
                            <option value="老年科">风湿免疫科</option>  
                            <option value="呼吸科">疼痛科</option>
                            <option value="血液科">中医结合科</option>  
                            <option value="皮肤科">肿瘤内科</option>
                            <option value="小儿内科">小儿内科</option>  
                            <option value="急诊内科">急诊内科</option>  
                            <option value="精神医学科">精神医学科</option>  
                            <option value="感染性疾病科">感染性疾病科</option>
                            <option value="肾移植科">肾移植科</option>  
                            <option value="腔内血管外科">腔内血管外科</option>
                            <option value="神经外科">神经外科</option>  
                            <option value="心血管外科">心血管外科</option>
                            <option value="肝胆外科">肝胆外科</option>  
                            <option value="胃肠外科">胃肠外科</option>  
                            <option value="肛肠外科">肛肠外科</option>  
                            <option value="胸外科">胸外科</option>
                            <option value="乳腺外科">乳腺外科</option>  
                            <option value="骨科">骨科</option>
                            <option value="血管外科">血管外科</option>  
                            <option value="泌尿外科">泌尿外科</option>
                            <option value="甲状腺外科">甲状腺外科</option>  
                            <option value="腹壁疝外科">腹壁疝外科</option>
                            <option value="小儿外科">小儿外科</option>  
                            <option value="烧伤与修复重建外科">烧伤与修复重建外科</option>
                            <option value="口腔科">口腔科</option>
                            <option value="眼科">眼科</option>  
                            <option value="耳科">耳科</option>
                            <option value="鼻科">鼻科</option>  
                            <option value="咽喉头颈外科">咽喉头颈外科</option>
                            <option value="眼科门诊">眼科门诊</option>  
                            <option value="视光诊疗部">视光诊疗部</option>
                            <option value="介入科">介入科</option>  
                            <option value="神经介入科">神经介入科</option>  
                            <option value="输血科">输血科</option>  
                            <option value="心电图">心电图</option>
                            <option value="麻醉科">麻醉科</option>  
                            <option value="体外支持中心">体外支持中心</option>
                            <option value="放疗科">放疗科</option>  
                            <option value="影像与核医学科">影像与核医学科</option>
                            <option value="核医学科">核医学科</option>  
                            <option value="放射科">放射科</option>  
                            <option value="磁共振">磁共振</option>  
                            <option value="产前诊断">产前诊断</option>
                            <option value="超声科">超声科</option>  
                            <option value="肺功能">肺功能</option>
                            <option value="儿科脑电图">儿科脑电图</option>  
                            <option value="气管镜">气管镜</option>
                            <option value="脑电图">脑电图</option>  
                            <option value="肌电图">肌电图</option>
                            <option value="消化内镜科">消化内镜科</option>  
                            <option value="检验科">检验科</option>
                            <option value="病理科">病理科</option>
                            <option value="血研室">血研室</option>  
                            <option value="儿科实验室">儿科实验室</option>
                            <option value="神经重症监护病房">神经重症监护病房</option>  
                            <option value="外科重症监护病区">外科重症监护病区</option>
                            <option value="心脏重症监护病区">心脏重症监护病区</option>  
                            <option value="呼吸重症监护病区">呼吸重症监护病区</option>
                            <option value="综合重症监护病区">综合重症监护病区</option>
                            <option value="小儿重症监护病区">小儿重症监护病区</option>  
                            <option value="急诊重症监护病区">急诊重症监护病区</option>
                            <option value="新生儿重症监护病区">新生儿重症监护病区</option>
                            
                        </select> 
                   </div>
                   <div class="form-group">
                        <select name="learnlength" class="form-control" >
                                <option>--请选择 单位为“月”--</option>  
                                <option value="1">1</option>  
                                <option value="2">2</option>  
                                <option value="3">3</option>  
                                <option value="4">4</option>
                                <option value="5">5</option>  
                                <option value="6">6</option>
                                <option value="7">7</option>  
                                <option value="8">8</option>
                                <option value="1">9</option>  
                                <option value="2">10</option>  
                                <option value="3">11</option>  
                                <option value="4">12</option>
                                <option value="5">13</option>  
                                <option value="6">14</option>
                                <option value="7">15</option>  
                                <option value="8">16</option>
                                <option value="1">17</option>  
                                <option value="2">18</option>  
                                <option value="3">19</option>  
                                <option value="4">20</option>
                                <option value="5">21</option>  
                                <option value="6">22</option>
                                <option value="7">23</option>  
                                <option value="8">24</option>
                        </select> 
                   </div>
                  <!--  <div class="form-group">
                        <label style="float: left; color: red;">请上传个人蓝底照片</label>
                        <input id="personalpic" class="form-control" type="file" name="personalpic" placeholder="上传个人照片" />
                   </div> -->


                    <div class="form-group"> 
                        <div class="fl">
                            <div class="file-container">
                                <button class="btn btn-success fileinput-button" type="button">请上传个人蓝底照片</button>
                                <input class="filed" type="file" name="personalpic" id="personalpic"  >
                                <span id="filename" style="vertical-align: middle">必须上传，否则无效</span>
                            </div>

                        </div>
                    </div>
                   
                
                    <input type="button" name="next" class="next action-button" value="下一步" />
                </fieldset>
    
                <fieldset>
                    <h2 class="fs-title">申请人基本情况</h2>
                    <h3 class="fs-subtitle">This is step 2</h3>
                    <div class="form-group">
                        <input class="form-control" type="text" name="institution" placeholder="工作单位" />
                    </div>
                    <div class="form-group">
                        <input class="form-control" type="text" name="linkman" placeholder="工作单位联系人" />
                    </div>
                    <div class="form-group">
                        <input class="form-control" type="text" name="linktel" placeholder="单位负责人电话" />
                    </div>
                    <div class="form-group">
                        <input class="form-control" type="text" name="doctorid" placeholder="执业医师证号" />
                    </div>
                    <div class="form-group">
                        <input type="text" class="form-control" name="location" placeholder="执业地点">
                    </div>
                    <div class="form-group">
                        <textarea class="form-control" name="field" placeholder="执业范围"></textarea>
                    </div>
                    <div class="form-group">
                        <textarea class="form-control" name="comment" placeholder="特殊情况说明"></textarea>
                    </div>
                    <div class="form-group"> 
                        <div class="fl">
                            <div class="file-container">
                                <button class="btn btn-success fileinput-button" type="button">执业医师证件照片(个人信息页)</button>
                                <input class="filed" type="file" name="doctorpica" id="doctorpica"  >
                                <span id="filename" style="vertical-align: middle">必须上传，否则无效</span>
                            </div>

                        </div>
                    </div>
                    <div class="form-group"> 
                        <div class="fl">
                            <div class="file-container">
                                <button class="btn btn-success fileinput-button" type="button">执业医师证件照片(执业信息页)</button>
                                <input class="filed" type="file" name="doctorpicb" id="doctorpicb"  >
                                <span id="filename" style="vertical-align: middle">必须上传，否则无效</span>
                            </div>

                        </div>
                    </div>
                    <div class="form-group"> 
                        <div class="fl">
                            <div class="file-container">
                                <button class="btn btn-success fileinput-button" type="button">医院营业执照(非公立医院请上传)</button>
                                <input class="filed" type="file" name="license"    >
                                <span id="filename" style="vertical-align: middle">必须上传，否则无效</span>
                            </div>

                        </div>
                    </div> 
                    <div class="form-group"></div>
                    <input  type="button" name="previous" class="previous action-button" value="上一步" />
                    <button type="submit" id="submit" class="action-button">提交</button>
                </fieldset>
        </form>
        <script src="../../../front/js/jquery.min.js"></script>
        <script src="../../../front/js/jquery.easing.min.js" type="text/javascript"></script>
        <script src="../../../front/js/daimabiji.js" type="text/javascript"></script>
        <script>
            function check(){
                var personalpic = document.getElementById("personalpic").value;
                var doctorpica = document.getElementById("doctorpica").value;
                var doctorpicb = document.getElementById("doctorpicb").value;
                var telphone = document.getElementById("telphone").value;
                if(personalpic.length==0)
                    {
                    alert("请上传个人照片");
                    return false;
                    }
                if(doctorpica.length==0)
                    {
                    alert("请上传执业医师证件照(个人信息页)");
                    return false;
                    }
                if(doctorpicb.length==0)
                    {
                    alert("请上传执业医师证件照(执业信息页)");
                    return false;
                    }
                if(telphone.length!==11)
                    {
                    alert("手机号码必须是11位");
                    return false;
                    }
                return true;
            }
            
            $(".filed").change(function(){  
                 $(this).each(function(){ 
                    var arr=$(this).val().split("\\");
                    var file_name=arr[arr.length-1];
                    $(this).next().html(file_name); 
                 })
            });
        </script>

      
   </body>
  
  <style>
.fl{float: left;}
.file-container{
        display:inline-block;
        position:relative;
        overflow: hidden;
        vertical-align:middle;
}
.filed{
        position:absolute;
        top:0;
        left:0;
        font-size:34px;
        opacity:0
}
  </style>
  
  </html>